CPT code 61703 is for a surgical procedure involving the treatment of an intracranial aneurysm using a cervical approach with an occluding clamp.
CPT code 61703 refers to a surgical procedure involving the treatment of an intracranial aneurysm. This specific procedure is performed using a cervical approach, which means accessing the area through the neck. The surgeon applies an occluding clamp to the cervical carotid artery, a major blood vessel in the neck that supplies blood to the brain. The clamp used is of the Selverstone-Crutchfield type, which is designed to temporarily or permanently restrict blood flow to the aneurysm, thereby reducing the risk of rupture. This procedure is typically performed by a neurosurgeon and requires precise skill to ensure the safety and effectiveness of the treatment.
For CPT code 61703, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the procedure required significantly more work than typically required. This could be due to increased complexity or difficulty.
2. Modifier 51 (Multiple Procedures): Apply this modifier if multiple procedures were performed during the same surgical session. This indicates that more than one procedure was carried out, which may affect reimbursement.
3. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 62 (Two Surgeons): If two surgeons were required to perform the procedure due to its complexity, this modifier should be used to indicate that both surgeons were necessary and actively involved.
5. Modifier 80 (Assistant Surgeon): Use this modifier if an assistant surgeon was required to help perform the procedure. This indicates that an additional surgeon was necessary to assist with the operation.
6. Modifier 81 (Minimum Assistant Surgeon): This is used when an assistant surgeon is required for a minimal portion of the procedure.
7. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Apply this modifier if an assistant surgeon was necessary because a qualified resident was not available.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines set forth by the American Medical Association (AMA) and payer policies to ensure accurate billing and reimbursement.
The CPT code 61703 is subject to reimbursement by Medicare, but it is essential to verify its status on the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate and any applicable conditions.
The MPFS provides a comprehensive list of services covered by Medicare, along with their respective payment rates. However, the final determination of reimbursement can also depend on the policies of the Medicare Administrative Contractor (MAC) that services your geographic region.
MACs are responsible for processing Medicare claims and can have specific guidelines or requirements that impact the reimbursement of certain CPT codes. Therefore, it is advisable to consult both the MPFS and your local MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 61703.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 61703, and by individual payer. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can enhance your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
